変形された抜毛癖(切毛癖)をもった一次性強迫性緩慢(<特集>痛みの行動療法(II))

概要

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The case of obsessional slowess, a 32 year-old female with altered tricotillomania, is reported. She appeares to have many of the features, which Rachman(1974)described and denoted as primary obsessional slowness. The treament and possible mechanism of the maintenance of slowness has been discussed. 1) The symptoms are characterized by meticulous replication and ritualization in almost all of the self-care behaviors, and by tendency to seek some sensation by behaving. Obsession and fear are moderate. 2) Therapeutic intervention such as modelling, instruction, pacing, response prevention, prompting, has been used for modification of slowness. Aversive treatment has also been used as modification of hair-cutting behavior. In a short period, changes of each self-care behavior was to a certain extent achieved relatively easily. However, changes reached a plateau after that. Improvement had no genegalization across target behaviors. Emotional discomfort during prevention was moderte. 3) These clinical findings suggestes that the obsessional slowness might not be an anxietyreducing mechanism which is the case in ordinary obsessional disorder. The possibility of that the slowness might function to avoid the situation to be doubted about her failure of each act, that is, to avoid appearance of obsession, has been considered. There has also been discussed about potential factor for maintaining compulsions could be in the behavio ritself.
1983-09-30